CIR: Veterans denied benefits due to VA errors

November 9, 2012 7:36:51 PM PST
Thousands of veterans around the country will spend Veteran's Day Sunday just like they did last year -- waiting to see if the Department of Veterans Affairs will grant them their disability claims. The Center for Investigative Reporting found that many of those veterans will be unfairly denied their benefits because of errors made by the VA.

"I knew it, I knew I should have been awarded that claim," said veteran Hosea Roundtree. "I knew I should have gotten that claim approved. I knew it."

In 2008, the Department of Veterans Affairs denied Roundtree's disability claim for post-traumatic stress disorder and depression. Roundtree asks, "What do you gotta do? Go get shot before you get PTSD? There's more than one way of getting wounded. I was mentally wounded." Roundtree was on a Navy destroyer in 1983 that engaged in battle off the coast of Beirut. But the VA says it couldn't find any evidence he was in combat.

"I just did a quick Google search on military history sites and I was able to verify that his ship that he was on was actually in combat," said Jamie Fox, a former claims processor at the VA's Oakland office. "I brought it to the attention of the supervisor, because I was new and I didn't know what to do."

Fox never saw Roundtree's file again. Five months later, she was forced out. Fox's termination letter said she was let go because she did not send Roundtree a letter denying his claim, "I was in shock, I was confused," said Fox.

Fox filed a wrongful termination suit against the VA. The agency declined several requests to discuss her case on camera. But in a deposition the former director of the VA's Oakland office did talk and shed light on how the agency is run. Lynn Flint said it "didn't matter" if the agency's decision in Roundtree's case was "right or wrong".

"They're not interested in quality," said attorney Gordon Erspamer. "They are interested in production and getting the decisions done, regardless of whether they are right or wrong." Erspamer has successfully sued the VA on behalf of veterans. He doesn't represent Roundtree or Fox, but he's not surprised by what happened to them, saying, "The system is simply broke. We can do a lot better for our veterans."

The VA says its error rate on disability claims is 14 percent. But the Center for Investigative Reporting analyzed a subset of those claims and found an error rate of 38 percent. And the Board of Veterans Appeals found the agency made mistakes in 73 percent of cases.

Erspamer says errors are often the result of a well-known practice at the VA, "There's a practice called topsheeting -- a very famous term at the VA. And that is basically you take a look at the file, you look at the top pages of the file, and you write a decision."

In a statement the VA says it is "retooling procedures and deploying paperless data systems" and trying to reduce its error rate to two percent by 2015.

Congresswoman Jackie Speier says, "I want to see dramatic changes taking place now." According to Speier, errors are contributing to the VA's huge backlog of disability claims, "There is no benefit in pushing a determination out that is wrong because in the end it will be appealed and it, it's going to make the record look even worse."

Appeals represent 31 percent of the agency's 819,000 pending disability claims. By the time Roundtree filed his first claim, he had spent 17 years in the Navy and more than a decade on the streets, addicted to drugs, "I lost it, I had a major breakdown," Roundtree said.

While he was waiting for the VA to process his claim, his family struggled financially. The same day he received his denial letter, he got a job offer from the VA's health care division. Now he works as a cook at the agency's medical center in Sacramento.

Fox now works for the same division of the VA that hired Roundtree, assisting veterans at a clinic in Santa Rosa. Her lawsuit is still pending.

This spring Fox says she found Roundtree on Facebook, "I was so nervous calling. I didn't know how he was going to respond." She heard what happened to his claim. And he heard what happened to her job. "I felt her pain, I felt her anger, I felt everything about her because she and I connected," Roundtree said.

A few weeks later, they met. And Fox convinced him to file a new disability claim.

"It's not just for me," said Roundtree. "It's for me and every other vet that's out there that's suffering. It's for every other vet that's coming back home so that they can see a difference. I want these vets coming back from overseas to get fair, better treatment."

Roundtree has been waiting five months to hear if the VA will approve his new claim. On average, veterans who submit claims to the Oakland office will wait a year for a decision.


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